Suchergebnisse

This work employs principles from across a range of sciences to refine the way we understand population health. By augmenting traditional analytic approaches with new tools like machine learning, microsimulation, and social network analysis, population health can be studied as a dynamic and complex system. This allows us to understand population health as a complex whole, offering new insights and perspectives that stand to improve the health of the public. The text offers the first educational and practical guide to this forward-thinking approach

Objectives: To characterize the prevalence of chronic cardiovascular conditions and risk factors among Arab American adults stratified by sex and compare these with non-Hispanic Whites.Design: Cross-sectional study using electronic health record data from visits be­tween January 2015 and December 2016. Age-adjusted prevalence estimates were cal­culated for men and women and compared using generalized linear models.Setting: Kaiser Permanente health plan in Northern California.Participants: Non-Hispanic White (N=969,566) and Arab American (N=18,072) adult members.Main Outcome Measures: Sex-stratified prevalence and prevalence ratios of diabe­tes, pre-diabetes, hypertension, and hyper­lipidemia diagnosed by December 2016 and of obesity, ever smoking, and current smoking status.Results: Arab American men had a significantly higher prevalence of ever smoking (41.8 vs 40.8%), diabetes (17.3 vs 12.5%), and hyperlipidemia (40.8 vs 34.7%) than White men, but a significantly lower prevalence of obesity (34.4 vs 37.8%) and hypertension (30.5 vs 33.3%). Arab American women had a significantly higher prevalence of diabetes (11.1 vs 8.7%) and hyperlipidemia (31.5 vs 28.3%) than White women but significantly lower prevalence of obesity (31.0 vs 34.2%), ever smoking (24.8 vs 34.5%), and hypertension (25.8 vs 28.4%).Conclusions: Hospital and health systems should intentionally collect data on Middle Eastern and North African ethnicity in electronic health records to identify and reduce the disparities this minority group faces.Ethn Dis. 2021;31(2):235-242; doi:10.18865/ed.31.2.235

Background: Relatively little is known about American medical student's attitudes toward caring for the uninsured, limiting physician reimbursement and the role of cost-effectiveness data in medical decision-making. We assessed American medical student's attitudes regarding these topics as well as demographic predictors of those attitudes, and compared them to practicing physicians. Methods and Findings: A survey instrument was explicitly designed to compare medical student attitudes with those previously reported by physicians. Between December 1st 2010 and March 27th 2011 survey responses were collected from more than 2% of the total estimated 2010–2011 US medical student population enrolled at 111 of 159 accredited US medical schools within the 50 United States (n = 2414 of possible 98197). Medical students were more likely to object to reimbursement cuts, and more likely to object to the use of cost effectiveness data in medical decision making than current physicians according to the literature. Specialty preference, political persuasion, and medical student debt were significant predictors of health policy attitudes. Medical students with anticipated debt in excess of $200,000 were significantly less willing to favor limiting reimbursement to improve patient access (OR: 0.73 [95% confidence interval (CI): 0.59–0.89]), and significantly more likely to object to using cost effectiveness data to limit treatments (OR 1.30, 95% CI 1.05–1.60) when compared to respondents with anticipated debt less than $200,000. Conclusions: When compared to physicians in the literature, future physicians may be less willing to favor cuts to physician reimbursements and may be more likely to object to the use of cost effectiveness data. Political orientation, specialty preference and anticipated debt may be important predictors of health policy attitudes among medical students. Early career medical providers with primary care ambitions and those who anticipate less debt may be more likely to support healthcare cost containment.